Attitudes towards the Effects of Covid-19 on the Environment

Research Article | DOI: https://doi.org/10.31579/2690-8808/014

Attitudes towards the Effects of Covid-19 on the Environment

  • José Marcos Bustos-Aguayo 1*
  • Javier Carreón-Guillén 2
  • Margarita Juárez-Nájera 2
  • Jorge Hernández-Valdés 1
  • Cruz García-Lirios 3 3

1Universidad Nacional Autónoma de México
2Universidad Autónoma metropolitana
3Universidad Autónoma del Estado de México

*Corresponding Author: Cruz García-Lirios, 3Universidad Autónoma del Estado de México

Citation: Bustos-Aguayo J M, Javier C Guillén, Margarita J Nájera, Jorge H Valdés, Cruz G Lirios, (2020) Attitudes towards the Effects of Covid-19 on the Environment. J Clinical Case Reports and Studies, 1(3): Doi: 10.31579/2690-8808/014

Copyright: © a-Lirios. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 06 June 2020 | Accepted: 05 July 2020 | Published: 07 July 2020

Keywords: Information; theory; model; attitude; behavior

Abstract

The objective of the present work was to specify a model for the study of attitudes towards the effects of the pandemic on the environment. An exploratory, cross-sectional and correlational work was carried out with 100 students, considering their confinement and intensive use of electronic technologies, devices and networks. A factorial structure was found that explained 35% of the total variance, although the research design limited the results to the study setting, suggesting the extension of the work towards the contrast of the proposed model.   

Introduction

As of this writing, the SARS-COV-2 coronavirus pandemic and COVID-19 disease have infected 10 million people, sickened 5 million and killed half a million. In Mexico, 200,000 have been infected, 50,000 have become ill and 25,000 have died. The health crisis has forced confinement and gradually led to a recession and economic crisis shaped by unemployment and inflation.
Faced with this bleak picture, people have developed attitudes or dispositions against and in favor of the situation, the government, their jobs, their families and themselves in the face of the health and economic crisis, highlighting the emotions of anxiety, anger or fear, although also dispositions emerge to carry out actions that mitigate the effects of the pandemic, as well as strategies for entrepreneurship and solidarity and fraternal collaboration with others.
Precisely, the objective of this work is to specify a model for the study of attitudes towards the pandemic, the rulers and the ruled, considering the effects of the health and economic crisis during a prolonged confinement that has lasted four months and another two are expected. Months more with the expectation of a new outbreak of infections, diseases and deaths.
The contributions of this work to the state of the question are: 1) review of the conceptual theoretical framework, 2) methodological approach to the problem, 3) diagnosis of the phenomenon, 4) discussion of the findings, 5) reflection of contributions and implications.

Thus, in the first section the theoretical and conceptual corpus that explain the appearance of attitudes towards risk events such as pandemics are exposed. Thus, in the following section the most recent and specialized findings are reviewed in order to be able to notice the research agenda. Next, the decisions that led to the study of the problem are presented to offer a diagnosis of the frequencies, validity and reliability of the responses to the instrument that measures the question. In addition, the scope and limits of work are discussed in a penultimate section in order to offer a global reflection in the last section. 

Theory of attitudes towards health
in this section, we review the theoretical and conceptual frameworks that include attitudes in explanatory and predictive models of behavior in specific situations, such as reasoned action and planned behavior.
Both theories, in the context of the confinement of people, the health crisis and the economic recession, anticipate scenarios of scarcity, shortages, unhealthiness and famine (Amemiya, 2020). These are predictive models of deliberate, planned and systematic behavior of individuals in favor of mitigation policies, use of masks, constant hand washing, application of tests, investment in treatments and vaccines.
In the 1970s a prolific context of explanatory corpus emerged, including the Theory of Reasoned Action. It was an approach that modeled attitudes as mediators of the effect of beliefs and values on human behavior (Anguiano, 2020). In the health field, reasoned action demonstrated a predictive power of self-care and adherence to treatment by anticipating risky situations and behaviors. It was the first conceptual framework dedicated to the study of relationships between health professionals and users of public health services.
The explanatory structure of the reasoned action consisted of associating the surrounding information about a disease with respect to the prevention strategies, the intentions to carry out a treatment and the adherence to that process (Garcia, 2020). However, very soon the studies revealed a low correlation between this surrounding information regarding the follow-up and execution of health recommendations.
Consequently, in the 1990s, a new proposal underlies those beliefs about the surrounding information in the media regarding the implementation of these recommendations (Hernández, 2020). The Theory of Planned Behavior, unlike reasoned action, raises a variable related to the control that people assume in the face of a disease. e is about perceived behavioral control which specifies people's beliefs and norms.
In other words, in the face of a widespread disease such as an epidemic or pandemic, a perception of control develops that regulates what the person believes in the information they receive (Molina, 2020). Such is the difference between reasoned action and planned behavior that the explanatory and predictive power is considerable.
It is possible to appreciate that attitudes are mediators of both processes, reasoning action and planned behavior, but in a confinement scenario, they regulate more information in planned behavior and therefore, self-care and adherence to treatment can be anticipated (Bustos, 2020).
In synthesis, both models, reasoned action and planned behavior, have turned out to be useful for the explanation and prediction of the prevention of a disease or adherence to its treatment. Both theories include attitudes as mediators or regulators of information beliefs and perceptions.

Attitude studies towards contingencies
this section presents the most recent studies on attitudes as mediators of beliefs and perceptions in their deliberate and planned process of incidence on intentions and behaviors. These investigations, in the context of the confinement of people, have anticipated the differences between those who are in favor of confinement policies and the spread of the infected, sick and dead versus those who avoid these contents or develop questions to their authorities.
Traditionally, attitudinal studies have focused on three dimensions related to feelings towards media information, the representation of data or images, as well as the intentions to carry out or not the recommendations of authorities (Limón, 2020). In the deliberate action process, attitudes are provisions against or in favor of mitigation policies, but it is in planned behavior that these provisions filter perceptions of control, delimiting information that will influence decision-making and execution of the action.
In this way, the three components of attitudes are information filters for more efficient, effective and effective decision making and execution (Pérez, 2020). Therefore, the modeling of attitudes in predicting behavior is preferably done from the cognitive rational component. It is a minuscule process where the information is processed in such a way that it will end up segmented into data, phrases or images that determine decisions and actions, both reasoned and planned.
In the case of the intentional component, the probability of carrying out an action will depend on the calculation of possibilities that the person performs when processing data, images or phrases (Rivera, 2020). Therefore, communication of risks around the pandemic is of vital importance.

In synthesis, the components; affective, cognitive and intentional attitudes filter data, images and phrases in order to define a decision and consequent action.

Modeling attitudes towards the effects of COVID-19 on the environment
In this space, the three components of attitudes are modeled, considering the beliefs and perceptions of the information disseminated in the media and their impact on prevention actions; confinement, use of masks, hand washing, diagnostic tests and healthy distance.

Based on the theoretical, conceptual and empirical frameworks reviewed, it is possible to model the explanatory variables of the media impact of the pandemic on the preventive behavior of people. It is a media phenomenon in that it is through television, radio, the press or networks that information on people, sick and dead from the COVID-19 disease is disseminated.
In the assumption that the government intends to mitigate the effects of the pandemic, reducing the number of risks, infections, sick and dead, the declaration of health contingency and the political communication strategy of risk control and management (Quiroz, 2020). Attitudes can emerge as predominant by filtering what the person believes or perceives about the pandemic.
In this scenario, cognitive attitudes are the most relevant because they process data, images and phrases of authorities in the face of the pandemic, although intentional and affective attitudes also stand out for receiving messages (Sandoval, 2020). The affective component activates negative and positive emotions and feelings towards the authorities, biasing their evaluation in the management of the health crisis.
However, by disseminating pandemic mitigation data, motivational phrases, or images of technological, organized, or scientific response, authorities reduce or increase those emotions of anger, anxiety, or fear. In this process, cognitive attitudes change a negative disposition into positive, or from positive to negative depending on the type of government message (Carreon, 2020).
In the case of intentions as a dimension of attitudes, they are determined by the filter of cognition. This is the case of people who declare not to believe in the pandemic but die from that neglect. This news or experience translates into a new provision that incorporates the high risk of contagion or death, causing preventive self-care.
In summary, the three components can be associated to process data, phrases or images in order to guide decisions and actions.
Now, in the case of attitudes towards the effects of COVID-19 on the environment, it is necessary to consider that the media have disseminated images and data on the decrease in air pollution, the visit of animals to cities, the purification of beaches or rivers, but also the increase in sanitary waste; masks, syringes, gowns, towels and sheets.

In these events, the three dimensions of attitudes; Emotional, cognitive and intentional can explain mobility, the consumption of products, and the use of energy or water in the face of confinement. In this sense, the combination of the dimensions of attitudes with the objects of affect, cognition and intention results in an inventory that the present work used to observe their distribution.

Methods

Design. An exploratory, cross-sectional and correlational work was carried out with a sample of 100 students ( M = 24.31 SD = 3.21; M = 9'975.32 SD = 743.23 monthly income) from a public university in central Mexico , considering prolonged confinement, as well as the intensive use of electronic technologies, devices and networks.

Instrument. The Attitudes Scale towards the Pandemic EAP-21) was built, which includes 21 assertions around three preponderant dimensions; emotional-affective-sentimental ("The coronavirus affects consumers "), cognitive ("The pandemic is an effect of climate change") and intentional-behavioral ("Ecologists work more in this confinement"). All items are answered with one of five options ranging from 0 = "not at all likely" to 5 = "quite likely".

Procedure. The invitations were sent to the institutional emails of the respondents. Once the acknowledgments were received, the informed consent was sent, highlighting the non-payment for responding to the questionnaire, as well as the guarantee of confidentiality and anonymity both in the coding and in the interpretation of the responses.
Analysis. The data were processed in the statistical analysis package for social sciences version 23.0 considering the requirements of normal distribution, reliability, adequacy, sphericity, validity, linearity, normality and independence for the structures of trajectories and relationships between the variables in order to to test the null hypothesis of significant differences between the structures reported in the literature with respect to the observations made in this work.

Results

Table 1 shows the values ​​of normality, reliability and validity among the variables that reflect the responses to the items that measure attitudes towards the pandemic, confinement and government action as a civilian in the face of health and economic crises.

Table 1. Descriptive of the instrument

Note: Made with the study data. Method: Main axes, Rotation: Promax. Emotions (16% of the total explained variance and alpha of, 780), Cognitive (12% of the total explained variance and alpha of, 765), Intentions (7% of the total explained variance and alpha of, 753). All items are answered with one of five options, ranging from 0 = "not at all agree" to 5 = "quite agree".

Establishing the exploratory factor structure of the three preponderant factors in relation to the 21 indicators, we proceeded to estimate the relationships between these three dimensions related to emotional, cognitive and intentional attitudes which explained 35% of the total variance (see Table 2).

Table 2. Relationships between variables.

Note: Made with the data from the study; * p <, 01; ** p <<, 001; *** p <, 0001

The relationship structure weighs the inclusion of another factor that the literature identifies as dispositional ambivalence to account for those attitudes against and in favor of an object which may be the case of the pandemic. In other words, on the one hand, negative provisions are built in the face of the health and economic crisis, but also unusual work opportunities such as messaging are opened. In this way, the possible emergence of this fourth factor was observed, although adjusting the three factors would also be an option to increase the percentage of explained variance.
The adjustment and residual parameters ⌠χ2 = 234.13 (24 gl ) p>, 05; CFI =, 990; GFI =, 999; RMSEA =, 008⌡ suggest the non-rejection of the null hypothesis regarding the significant differences between the reflective trajectory structure subtracted from the literature with respect to the observed relationship structure.

Discussion

The contribution of the present work to the state of the question lies in the establishment of the reliability and validity of an instrument that measures attitudes towards the effects of the pandemic on the environment, suggesting the extension of the work towards contrasting the model in others. Scenarios.
In relation to the theory of attitudes, which highlight the three emotional, cognitive and intentional components, this work has shown the prevalence of this structure of reflective trajectories in a model, but the percentage of total variance suggests the inclusion of an ambivalent factor. Which would increase the predictive power of the model. In the virtual classroom the application of this finding in the didactic sequences will allow to establish dynamics oriented towards ambivalence; emotionality and reasoning about its effects on public resources and services.

As for the studies of attitudes which highlight the hegemony of the emotional component in the event of risk events, this work has shown that it is a multiple dimension in which indicators adjusted to anger, fear or anxiety converge in the face of the effects of pandemic in nature. These results will allow the design of pedagogical sequences related to education for sustainability, mainly regarding risk events.

Theoretical, conceptual and empirical frameworks seem to highlight the hegemony of cognitive dispositions to explain the emergence of attitudes to risk events such as a pandemic. In this sense, the present investigation has highlighted the factorial structure that explains the relationships between the affective, cognitive and intentional dimensions as a formative process of dispositions against or in favor of the effects of the coronavirus in nature.

However, regarding studies of attitudes towards the effects of the pandemic in the environment, which highlight the cognitive component, this work has shown that it explains a percentage of variance less than the affective dimension. This is so because the pandemic has been processed as a collateral problem to atmospheric and water pollution. Research lines related to these two dimensions in a health contingency situation will anticipate the effects of the pandemic on energy, gasoline or water users.

Regarding the products derived from the confinement of people; towels, masks, soap, water, alcohol or gel these could be objects of consumption and predictable from the cognitive dimension, but when the affective component prevails, they are processed as impositions rather than as preventive instruments. In other words, the effects of the pandemic on the environment seem to be related to fear, anger or anxiety rather than to processes of utility, benefit or gain.
In other words, affective attitudes prevail more than cognitive and intentional attitudes because the media and government health policy have focused their attention on the confidence of the governed rather than on their discipline or experience with epidemics. It is necessary to carry out studies that establish these communication differences between rulers and citizens in order to be able to observe the differences between attitudes of an affective order with respect to those of a cognitive or intentional order.

Conclusion

The contribution of the present work to the state of knowledge lies in the specification of a model for the study of attitudes towards pandemic effects in nature, although the research design limited the results to the work setting, suggesting the extension of this to a context of risk events.

In consultative terms, research provides the central elements for the construction of an environmental policy focused on the cognition of dispositions. It is about the design of pedagogical sequences oriented towards local sustainability in the management of municipal resources and services. In other words, from the construction of a public agenda it will be possible to discern between the deliberate, planned and systematic reasoning emerging from the pandemic, confinement and the health and economic crises.

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad